Intracranial atherosclerotic stenosis (ICAS) is one of the most common causes of ischemic stroke. Stenting is a treatment option for symptomatic ICAS, but it also has problems such as procedure-related complications and in-stent restenosis. This article reviews the application of stenting, particularly different stent systems, in patients with symptomatic ICAS.

BACKGROUND:Wogonin is a flavonoid extracted from the root of Scutellaria baicalensis.Previous studies have shown that baicalein has protective effects against cerebral ischemia-reperfusion injury,and can also reduce blood sugar and complications in diabetic mice,but its role and mechanism in diabetic cerebral infarction remain unclear. OBJECTIVE:To explore the effect of wogonin on nerve injury in rats with diabetic cerebral infarction and its mechanism. METHODS:Sprague-Dawley rats were randomly divided into six groups:control group,model group,low-dose wogonin group,medium-dose wogonin group,high-dose wogonin group,and high-dose wogonin+Ras homolog gene family member A(RhoA)activator group.Except for the control group,the other rats were established with diabetes and cerebral ischemia models using intraperitoneal injection of streptozotocin and middle cerebral artery occlusion.Low,medium-and high-dose wogonin groups were intragastrically given 10,20,40 mg/kg wogonin,respectively;high-dose wogonin+RhoA activator group was intragastrically given 40 mg/kg wogonin and intraperitoneally injected 10 mg/kg lysophosphatidic acid;control group and model group were given the same amount of normal saline once a day for 7 consecutive days.Rats in each group were evaluated for neurological deficits and their blood glucose levels were measured after the last dose.TTC staining was applied to detect the volume of cerebral infarction.Hematoxylin-eosin staining was applied to observe pathological changes in brain tissue.ELISA kit was applied to detect tumor necrosis factor-α,interleukin-6,malondialdehyde,and superoxide dismutase levels in brain tissue.Western blot was applied to detect the protein expression of RhoA and Rho-associated protein kinase(ROCK)2 in brain tissue. RESULTS AND CONCLUSION:Compared with the control group,the neuronal structure of rats in the model group was severely damaged,with cell necrosis and degeneration,the neurological deficit score,blood glucose level,and infarct volume were significantly elevated(P<0.05),the levels of tumor necrosis factor-α,interleukin-6,and malondialdehyde,and the protein expression of RhoA and ROCK2 in brain tissue were significantly increased(P<0.05),and the superoxide dismutase level was decreased(P<0.05).Compared with the model group,the low-,medium-,and high-dose wogonin groups showed improved neuronal damage,reduced cell degeneration and necrosis,a significant reduction in neurological deficit score,blood glucose level,infarct volume,and the levels of tumor necrosis factor-α,interleukin-6,and malondialdehyde,and the protein expression of RhoA and ROCK2 in brain tissue,and an increase in the superoxide dismutase level(P<0.05).Compared with the high-dose wogonin group,the high-dose wogonin+RhoA activator group significantly weakened the improvement in the above indexes of rats with diabetic cerebral infarction(P<0.05).To conclude,wogonin can improve the blood glucose level in rats with diabetic cerebral infarction,reduce cerebral infarction and nerve injury,and its mechanism may be related to the inhibition of RhoA/ROCK signaling pathway.

Cubital tunnel syndrome is a common peripheral nerve entrapment disorder, which may lead to significant functional impairment in severe cases due to intrinsic hand muscle atrophy. As the disease progresses, clinical prognosis of cubital tunnel syndrome tends to decline, particularly in functional recovery. Traditional treatment strategies have been proven ineffective in restoring intrinsic hand muscle function postoperatively in severe cases. Transposition of motor branch of pronator quadratus surgery has emerged as a solution, offering a better therapeutic option for the patients. This procedure involves end-to-side anastomosis of the pronator quadratus muscle branch with the deep branch of ulnar nerve, introducing additional axons to promote nerve regeneration and providing a novel strategy for functional recovery. Transposition of motor branch of pronator quadratus surgery significantly improves strengths in gripping and pinching as well as fine motor function in patients with severe cubital tunnel syndrome, with notable enhancements in postoperative electrophysiological indicators and improvement of quality of life. The mechanism of it is based on the principles of nerve regenerative biology, utilizing collateral sprouting of axons from the pronator quadratus muscle branch and the supportive microenvironment of distal Schwann cells to achieve reinnervation of target muscles. This article reviews the definition, mechanism, anatomical basis, classification of cubital tunnel syndrome, surgical indications and clinical efficacy of transposition of motor branch of pronator quadratus surgery, intended to provide reference opinions for clinical doctors to gain a deeper understanding and rational application of transposition of motor branch of pronator quadratus.

Objective:To analyze the seroepidemiological characteristics of common respiratory pathogens in patients screened at a tertiary hospital in Zhangjiakou from 2018 to 2024.Methods:This single-center cross-sectional study utilized data from the laboratory information management system (LIS) of The First Affiliated Hospital of Hebei North University. We collected clinical data and serum-specific IgM antibody test results for 11 common respiratory pathogens ( influenza A virus, influenza B virus, respiratory syncytial virus, parainfluenza virus, mycoplasma pneumoniae, chlamydia pneumoniae, legionella pneumophila, coxsackie A virus, coxsackie B virus, echovirus and adenovirus), excluding SARS-CoV-2, from January 1, 2018, to December 31, 2024. Comparative analyses were conducted across three periods: 2018-2019, 2020-2022, and 2023-2024. Statistical analyses were performed using SPSS 26.0, with categorical data presented as percentages and compared using χ2 tests. Results:From 2018 to 2024, a total of 35 665 patients with respiratory tract infection were screened, of which 10 531 were positive for at least one pathogen, with a total positive rate of 29.53% (10 531/35 665). Age-adjusted positive rates were highest in 2023-2024 compared to 2018-2019 and 2020-2022 ( χ2=690.789, P<0.001). The specific data are as follows: 21.35% (2 476/11 598) in 2018-2019, 24.35% (2 942/12 081) in 2020-2022, and 35.73% (4 283/11 986) in 2023-2024. Among the 11 pathogens, mycoplasma pneumoniae had the highest overall positivity rate (11.99%, 4 278/35 665), followed by influenza B virus (10.83%, 3 861/35 665), the other nine pathogens showed lower rates (0.88%-4.97%). At different time stages, the positive rates of serum IgM antibodies of various pathogens showed different changing characteristics: in 2023-2024, the positive rates of serum specific IgM antibodies against mycoplasma pneumoniae, influenza B/A virus and adenovirus increased significantly compared with those in 2020-2022, from 10.35%, 11.91%, 3.68%, 0.43% to 12.11%, 14.97%, 5.37%, 4.43% respectively ( χ2=59.150, P<0.001; χ2=579.484, P<0.001; χ2=116.263, P<0.001; χ2=654.125, P<0.001). The positive rates of serum IgM antibody in patients of different age groups also showed different changing trends. In 2023-2024, the proportion of people in 18 to 60 and ≥60 age groups increased compared with that in 2018-2019 ( χ2=325.069, P<0.001; χ2=593.612, P<0.001), while the 0 to 3, 3 to 6, and 6 to 12 age groups showed declines ( χ2=382.067, P<0.001; χ2=252.835, P<0.001; χ2=285.888, P<0.001). Regarding the composition of serum IgM antibodies in different infection patterns, the proportion of single-pathogen infections decreased in 2023-2024 compared with that in 2018-2019 ( χ2=130.19, P<0.001), while the proportion of two and three pathogen co-positive increased ( χ2=65.533, P<0.001; χ2=46.836, P<0.001).The most common single-pathogen infections were mycoplasma pneumoniae, influenza B/A virus and legionella pneumophila; the predominant dual-pathogen combinations were influenza A+B viruses, influenza B virus+ mycoplasma pneumoniae, and mycoplasma pneumoniae+ legionella pneumophila. Conclusion:From 2018 to 2024, the seroepidemiological characteristics of common respiratory pathogens changed significantly with different time stages. The positive rate of serum-specific IgM antibodies were influenced by the social environment and public health intervention measures. Serological testing is an important means for the monitoring of respiratory pathogens and the prevention and control of infections in this region.

Objective To study the effect of diltiazem on coronary microcirculation and vascular endothelial function in patients with acute coronary syndrome(ACS)before surgery.Methods A total of 96 ACS patients admitted to Fengfeng General Hospital of North China Medical and Health Group between October 2023 and October 2024 were selected as subjects.The patients were divided into experimental group(n=48)and control group(n=48)by using a random number table method.The experimental group received slow intravenous infusion of diltiazem dilution before surgery and continued intravenous diltiazem during the procedure,while the control group received normal saline both preoperatively and intraoperatively.During the operation,coronary microcirculation parameters[coronary angiography,myocardial perfusion grading(TIMI),microcirculatory resistance index,intraoperative slow blood flow,and no-reflux status]were monitored.Vascular endothelial indexes(endothelin-1,vascular endothelial growth factor)were detected before and one week after surgery.Cardiovascular adverse events were also observed within six months postoperative.Results Postoperative TIMI myocardial perfusion grading in experimental group was superior to than that in control group,and the incidence of slow blood flow and no reflux during surgery in experimental group were lower than those in control group.The levels of endothelin-1 and vascular endothelial growth factor in experimental group were lower than those in control group,and the incidence of cardiovascular adverse events in experimental group were lower than those in control group,with statistically significant differences(P＜0.05).Conclusion The use of diltiazem before percutaneous coronary intervention in patients with ACS can effectively increase coronary blood flow,improve coronary microcirculation,and protect vascular endothelial function.

Objective To investigate the correlation between novel bone metabolism markers and the degree of aortic calcification as well as cardiovascular event risk in elderly patients treated by PD.Methods A prospective trial was conducted on 230 elderly patients receiving continuous am-bulatory PD in our department from February 2022 to February 2024.According to the occur-rence of cardiovascular events during dialysis treatment,they were divided into a cardiovascular event group(n=92)and a control group(n=138).Relevant clinical data were collected,aortic calcification was assessed using AAC scores,and serum levels of bone metabolism markers,inclu-ding osteoprotegerin,TRACP,and PINP were measured.Results The serum levels of osteoprote-gerin,TRACP and PINP were significantly higher in the cardiovascular event group than the con-trol group(P＜0.01).The cardiovascular event group had obviously severe calcification and higher AAC score than the control group(P＜0.01).The serum levels of the three bone metabolism markers were notably higher in the patients with severe calcification than those with moderate calcification,followed by mild calcification in turn(P＜0.01).Spearman correlation analysis indi-cated that the levels of the three indicators were positively correlated with the degree of aortic cal-cification in elderly PD patients(r=0.465,P=0.000;r=0.396,P=0.000;r=0.434,P=0.000).Multivariate logistic regression analysis showed that these three indicators were risk factors for cardiovascular events in elderly PD patients(P＜0.01).Conclusion The three bone metabolism markers are significantly correlated with aortic calcification severity and cardiovascular event risk in elderly PD patients.Monitoring these marker levels may be helpful for the assessment and man-agement of cardiovascular risk.

Objective To investigate the role of additional platelet protein kinase C epsilon(PKCε)assay in risk stratification and additional diagnostic testing in elderly patients with acute chest pain and normal hypersensitive cardiac troponin I(hs-cTnI)level.Methods A prospective trial was conducted on 220 consecutive elderly patients with angina-like acute chest pain and normal hs-cTnI level in our hospital from April 2022 to April 2023.According to whether major adverse cardiovascular events(MACE)occurred during the 1-year follow-up period,they were assigned in-to MACE group(24 cases)and non-MACE group(196 cases).Their general clinical data and platelet PKCε expression were compared between the two groups.Kaplan-Meier survival curve was plotted to analyzed the event-free time between the platelet PKCε expression＜2.05％group and the≥2.05％group.Multivariate Cox regression analysis was used to investigate the impact of baseline data on the occurrence of MACE during the 1-year follow-up period.Decision tree model was employed to analyze the influencing factors for MACE.Results During 1-year follow-up,24 patients(10.91％)developed MACE.The platelet PKCε expression was significantly higher in the MACE group than the non-MACE group[9.25％(6.60％,15.25％)vs 1.70％(0.80％,3.25％),Z=-7.596,P＜0.01].Kaplan-Meier survival curve analysis showed that the patients in the PKCε＜2.05％group had no events within 360 d,while those in the ≥2.05％group had an average event-free time of 297.13±12.77 d,with a statistical difference(log rank Chi-square=27.051,P=0.000).Multivariate Cox regression analysis showed that highly suspicious angina,hs-cTnI and platelet PKCε were independent risk factors for MACE within 1 year of follow-up(HR=3.011,95％CI:1.049-8.641,P=0.040;HR=1.216,95％CI:1.044-1.418,P=0.012;HR=1.160,95％CI:1.104-1.218,P=0.000).In the decision tree model,the 1-year incidence of MACE was notably higher in the platelet PKCε≥2.05％group than the＜2.05％group(P=0.011).The probability of severe coronary artery stenosis or myocardial ischemia in the platelet PKCε≥2.05％group was remarkably higher than the＜2.05％group(P=0.006).Conclusion In elderly patients suffering from acute chest pain with normal hs-cTnI level,additional platelet PKCε detection appears to have a good prognostic gain.

Objective To determine the effect of baicalein on high glucose-induced cardiac fibro-blast pyroptosis based on the nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)/cysteinyl aspartate-specific proteinase-1(Caspase-1)/gasdermin D(GSDMD)pathway.Methods Rat cardiac fibroblasts were grouped into control,high glucose group,low-,medium-and high-dose baicalein(H-,M-and L-baicalein)groups,and H-baicalein+NLRP3 agonist(BMS-986299)group.Except for the control group,all other groups were cultured in DMEM medium containing 40 mmol/L glucose,then 12.5,25 and 50 μmol/L baicalein was added into the medium correspondingly,and 1 μmol/L BMS-986299 was used to treat the H-baicalein+NLRP3 agonist group.Lactate dehydrogenase(LDH)cytotoxicity assay were employed to detect cell cytotoxicity.qRT-PCR and Western blotting were performed to determine the expression of NLRP3,Caspase-1,and GSDMD at mRNA and protein levels.Results High glucose treatment induced more EdU positive cells,higher pyroptotic rate,stronger cytotoxicity,higher Col-Ⅰ and Col-Ⅲ contents,and enhanced mRNA and protein levels of NLRP3,Caspase-1 and GSDMD in comparison to the control group(P＜0.05).The H-baicalein+NLRP3 agonist group had more EdU positive cells(26.85±2.95 cells vs 15.43±1.82 cells,P＜0.05),higher pyroptotic rate[(33.45±4.02)％vs(17.34±2.15)％,P＜0.05],stronger cytotoxicity[(27.94±2.93)％vs(14.13±1.87)％,P＜0.05],and increased contents of Col-Ⅰ(107.58±13.39 ng/ml vs 58.73±8.36 ng/ml,P＜0.05)and Col-Ⅲ(118.43±13.95 ng/ml vs 68.74±8.57 ng/ml,P＜0.05),and enhanced expression of NLRP3,Caspase-1 and GSDMD at both mRNA and protein levels(P＜0.05)when compared with the H-baicalein group.Conclusion Baicalein inhibits high glucose-induced cardiac fibroblast pyroptosis by suppressing NLRP3/Caspase-1/GSDMD pathway.

Objective To explore the research status,hotspots and future development trends of traditional Chinese medicine in the field of multiple myeloma(MM)treatment in the past 20 years.Methods Retrieve the relevant literatures of traditional Chinese medicine in the field of MM treatment included in CNKI,Wanfang Data Knowledge Service Platform and VIP database from January 2004 to April 2024.The NoteExpress software was used for merging and deduplication,and the CiteSpace6.3.R1 software was used for visual analysis of the authors,research institutions and key words of the included literatures.Results A total of 420 literatures were included,and the overall number of published articles showed an upward trend.The author with the highest number of articles was Zhou Yuhong,with a total of 25 core authors.The institution with the highest number of published articles was the Affiliated Hospital of Shandong University of Traditional Chinese Medicine.A total of 277 key words were obtained.Through the induction of high-frequency key words,it could be seen that the current research hotspots focus on aspects such as the pathogenesis,chemotherapy drugs,adverse reactions,and treatment based on syndrome differentiation in traditional Chinese medicine.Conclusion The research interest in the Chinese medicine treatment of MM is increasing.The research topics currently attracting the most attention are the single active ingredient of Chinese medicine,the experience of renowned medical practitioners,the treatment of associated complications,and the combined use of Chinese and Western medicines.The research focus in the future will be on the mechanism pathway and the Chinese medicine characteristic therapy to enhance the quality of life of patients.

Objective:To analyze the occurrence and relevant factors associated with non-curative resection following endoscopic submucosal dissection(ESD)in elderly patients with early gastric cancer(EGC), as well as to establish a predictive model.Methods:Elderly patients diagnosed with EGC and treated at the First Affiliated Hospital of Hebei North University between January 2019 and January 2023 were retrospectively selected for this study.All patients underwent ESD surgery and were categorized based on the occurrence of non-curative resection( n=44)versus curative resection( n=284).Relevant factors contributing to non-curative resection after ESD surgery in elderly EGC patients were analyzed using both univariate and multivariate analyses.A predictive model was developed, and the receiver operating characteristic(ROC)curve was generated to assess its efficacy. Results:In this study, we analyzed a cohort of 328 elderly patients diagnosed with EGC, aged between 60 and 88 years, with a mean age of 70.87±2.67 years, of which 211 were male.Non-curative resection was performed in 44 cases, accounting for 13.41% of the cohort.Compared to the curative group, the non-curative group exhibited a significantly larger lesion diameter, greater infiltration depth into the submucosa, a lower degree of differentiation, a higher prevalence of undifferentiated types, and an increased fold interruption ratio(all P<0.05).Multivariate logistic regression analysis identified increased lesion diameter( OR=2.380, 95% CI: 1.361-4.160), invasion depth into the submucosa( OR=1.824, 95% CI: 1.120-2.971), undifferentiated degree( OR=1.960, 95% CI: 1.286-2.987), and fold interruption( OR=2.094, 95% CI: 1.384-3.166)as significant predictors of non-curable resection following ESD in elderly patients with EGC(all P<0.05).These factors were incorporated into a predictive model represented by the equation: logit( P)=-6.307+ (lesion diameter × 0.867)+ (infiltration depth into submucosa × 0.601)+ (undifferentiated degree × 0.673)+ (fold interruption × 0.739).The ROC curve analysis yielded an area under the curve(AUC)of 0.859, with diagnostic sensitivity and specificity of 84.09% and 74.65%, respectively. Conclusions:There are numerous relevant factors influencing non-curable resection following ESD surgery in elderly patients with EGC.The prediction model developed herein can serve as a foundation for identifying high-risk patients and formulating effective clinical intervention strategies.